User's Manual

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Therapy Activity 2: Hot Air Balloon
Hot Air Balloon is an introductory activity to help the patient work on core control and
strength as well as centering and postural proprioception. By leaning their torso from
a sitting position in a certain direction, and holding it there against gravity, they fly a
hot air balloon in that same direction. There are a number of objectives the patient
can achieve by flying the balloon around. To fly the balloon away and towards them,
the patient uses thoracolumbar flexion and extension, and to fly from left to right
involves thoracolumbar flexion to the left or right. This set of activities provide a range
of challenges focusing on enhancement of trunk control, postural stability, and
dynamic balance, all of which are foundational to upper extremity function. HCPs may
adjust various activity parameters through the tablet.
Sub-Activity 1: Balloon Pilot
This sub-activity takes place near the ground. The patient-controlled balloon is
tethered to the ground to limit balloon travel and encourage simple torso centering,
trunk mobility, and dynamic weight shifting. The patient can pilot the balloon on-tether
to nearby interactive objects.
Sub-Activity 2: Bumper Band
This sub-activity takes place halfway up the mountainside. The patient uses trunk
extension, flexion, as well as lateral flexion to drive the balloon in an untethered mode
to bump other balloons with characters in them, back to the performance stage.
Sub-Activity 3: Summit Rescue
This sub-activity takes place at the peak of the mountain where the player has to steer
the balloon to bring hikers which made it to the summit. The patient has to counteract
different obstacles using cognitive planning, problem solving, and trunk control
movements.
Therapy Activity 3: Sunrise
This activity is based on simple shoulder flexion. The patient holds their arms out
straight in front of them and raises their arms up and over their head in a motion that
ideally, is pure shoulder flexion with a maximum, healthy ROM of 180 degrees. This
exercise may be done passively with HCP assistance or actively by the patient
themselves. This exercise encourages postural alignment and symmetrical seated
shoulder flexion.
When this motion is initiated, a Sun character rises up from beyond the horizon in
proportion to the patient’s shoulder flexion ROM. The sun also rotates in the sky and
translates side to side, depending on the patient’s postural symmetry. When the
patient’s arms are horizontally and vertically symmetric, and their torso is in vertical
alignment with their pelvis and head, the sun will be smiling broadly and high in the
sky straight ahead of the patient.
If the patient’s posture exhibits asymmetry or other compensating characteristics, the
sun’s position and the expression on its face will alter from the “ideal” state, thereby
providing the patient an external visual cue as to their posture, and allowing them to
learn via alternative references, what is proper, non-compensating posture. Maximum
shoulder flexion ROM achieved during this activity will be stored as a session output
for the HCP’s record. HCPs may adjust various activity parameters through the tablet.
Sub-Activity 1: Sunrise
As the patient fully lowers and fully raises their arms to the best of their ability, the
lighting in the virtual world will exhibit night-time or daytime according to the sun’s
position, thus greatly accentuating the activity and feedback of a simple coordinated
arm raise.
Sub-Activity 2: Harvest
The Harvest sub-activity involves growing a variety of vegetables by raising and
lowering one’s arms a number of times in order to trigger the appearance of day-